Retention and Selection of Health Care Staff
(Team based turnover reduction)

In healthcare, nothing is more critical than providing consistent service on a daily basis. This is accomplished through the efforts of dedicated individuals on a continuing basis. The relationship of staff turnover to consistent service is well documented and consistent with our research.

Turnover costs of an entry-level health care worker is a minimum of $2,000 per employee. This cost merely includes the basics of certification, orientation, advertising, unemployment compensation, administrative costs and other direct costs. Costs actually run much higher when morale issues, marketing concerns, survey compliance and overall missed goal accomplishments of the organization are included. Thus, health care organizations must develop a specific and dedicated breakthrough strategy for the retention of their health care workers.

It is not enough to place this responsibility in the hands of a few people such as the administrator, director of nursing or human resource professional. There must be a targeted team effort to make training and retention a top priority. In addition, the ability to provide consistent service delivery on a daily basis gives you an advantage in the marketplace. To accomplish this goal, our Workforce 21 Recruitment, Selection and Retention program includes implementing the following:

SUPER TEAM:

A "super team" of 10-12 individuals chaired by the administrator or organization executive would be created to direct the project. In addition to the executives, a human resource professional and director of nursing services should also be on the team. These three individuals would recruit the remaining team members to include several nursing assistants, specific nursing leadership (unit managers, shift supervisors, etc) and other department management/staff. The team should be cross functional, not just a management team but extend deep into the organization with dedicated individuals.

THE PLAN:

The team will develop a written 12-week plan to be signed off all team members. They would be responsible to submit a weekly progress report to a higher level individual for accountability purposes. That individual could be the administrator's supervisor or board director. The written 12-week plan must encompass critical issues that affect the facility's ability to train and retain healthcare care workers. The 12-week team will focus on three major areas: how to recruit, select and retain quality employees.

PASSIONATE ORIENTATION:

One important issue the organization should address is the particulars of implementing a passionate orientation. Facilities spend time recruiting but rarely take time to train new employees appropriately. Passionate orientation must include a customized checklist for each position. New employees should be required to demonstrate their learning from a checklist for an assurance they received information in an appropriate manner and that they can demonstrate utilization. As a third component of passionate orientation, a mentor would be designated with a parallel schedule to the new employee. The mentor should be rewarded or recognized for helping that new employee complete the orientation process and acclamation to the organization.By developing a passionate orientation process and assuring it is meaningful and enjoyable for the new worker, you will reengineer the methodology that is a significant component of whether an individual is going to stay. People make retention judgements in the first 3-4 days they're working in a location. It is the facility's job to ensure this orientation and acclamation process is "passionate".

RETENTION:

The team should focus on what it takes to work with the current workforce in the new millennium. This must include how to make the workplace enjoyable and meaningful at the same time. It is not enough anymore to have a good job and plan to enjoy life in your later years. Today's younger health care workers want to be involved in a process that allows them to experience meaning and enjoyment now and at home and work…at the same time.To assist in this end, the team should work on issues associated with work scheduling; including how to involve units in a team based system rather than centralized scheduling. Health care workers joining the profession are younger, and want to be involved in determining their time off. If your centralized schedule model isn't working and time is spent begging, borrowing or stealing help, it would be worthwhile to consider alternatives including employee involvement in the scheduling process. (For more information on team based scheduling, please go to (name of article & link).The organization should also prepare a data assessment of why retention is a problem. This would include the development of specific exit interviewing processes upon the transfer or loss of an employee. There should also be an Employee Opinion Survey initiative to achieve an objective view of what's occurring. You should have Customer Satisfaction Surveys in place that would help retain workers by providing specific feedback about service delivery. It is a positive motivator for staff to be involved in direct feedback from customers. In addition, it would be helpful to do periodic salary and benefit studies to see if we're competitive in the marketplace.It is not enough to say we have a certain percentage of turnover in the organization, we must look at the specific units, departments and shifts where turnover is occurring at a higher pace.

SELECTION:

Upon the development and implementation of your retention efforts, focus on the selection process. Teams should be involved in the process; i.e., staff should assist in making hiring recommendations. When the staff helps select their co-workers they develop a sense of ownership in the decision. The organization should develop some form of behavioral interviewing process where the questions asked allows the applicant to tell a story about how they have conducted themselves in the past to determine if that's what we're looking for. By setting up the questions in advance, it allows us to move away from a "gut feeling" approach to interviewing. (For more information on behavioral interviewing, {click here}).

RECRUITMENT:

Do not place classified ads that give the perception, "wanted, we're desperate, we need many". Instead, develop targeted ads that focuses on the great talent in the building with stories about individuals that have performed acts of courage and put forth extra efforts..."We're looking for people like this type of individual". Matching talent to talent puts us in a position of using team-based recruitment. Individuals in the organization should be responsible for putting together the ad campaign, flyer distribution and developing word of mouth referral sources which are critical for success. Set up a recruitment campaign that is targeted, focused and talent based. Select people who find it an honor to work with us and we'll show them it is an honor to have them.

SUMMARY:

The 12-week Super team selects topic areas to work on with specific goals and targets for weekly accomplishment. They should assign action and accountability to individuals on that team with sub-teams to work on specific areas. There should be a weekly meeting of the "super team" with the sub-team meetings as necessary. This should take priority in the organization. It should be broad based, targeted and team oriented if we hope to move ourselves to a consistent service delivery position that our customers, clients, residents deserve.

Copyright 2002 Maun-Lemke, Inc.